MercyOne West Des Moines Medical Center
1755 59th Place, West Des Moines, IA · MercyOne · · NPI 1538395975
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Covid-19 IV infusion and post admin monitoring tocilizumab 2nd dose HCPCS M0250 | $683.00 | $683.00 | $81.00 – $683.00 | 28 |
| CPAP or BiPAP Setup (first day) CPT 94660 | $1,489.00 | $1,489.00 | $189.00 – $1,482.00 | 110 |
| C-peptide CPT 84681 | $281.00 | $281.00 | $20.17 – $281.00 | 44 |
| CPR (Cardiopulmonary Resuscitation) CPT 92950 | $15,698.50 | $2,337.00 | $108.63 – $2,337.00 | 780 |
| Cr-51 sodium chromate HCPCS A9553 | $7,028.75 | $7,028.75 | $471.37 – $7,028.75 | 28 |
| C-reactive protein CPT 86140 | $302.00 | $302.00 | $5.02 – $302.00 | 44 |
| C-reactive protein high sensitivity CPT 86141 | $217.00 | $217.00 | $12.55 – $217.00 | 44 |
| Creatine kinase CPT 82550 | $221.00 | $221.00 | $6.30 – $214.00 | 44 |
| Creatine kinase isoenzymes CPT 82552 | $133.00 | $133.00 | $12.97 – $127.00 | 44 |
| Creatine kinase mb CPT 82553 | $228.00 | $228.00 | $11.19 – $228.00 | 44 |
| Creatinine CPT 82565 | $39,842.13 | $118.00 | $4.96 – $13,116.76 | 110 |
| Creatinine 24 hour urine CPT 82570 | $164.00 | $164.00 | $5.02 – $61.00 | 44 |
| Creatinine clearance urine CPT 82575 | $193.00 | $193.00 | $9.17 – $193.00 | 44 |
| #creutz-prot.,western blot CPT 84182 | $70.00 | $70.00 | $14.07 – $70.00 | 44 |
| Critical care each additional 30 minutes CPT 99292 | $1,330.00 | $1,330.00 | $56.25 – $1,330.00 | 779 |
| Critical Care (first 30 to 74 minutes) CPT 99291 | $5,117.00 | $5,117.00 | $126.95 – $5,117.00 | 780 |
| Crizanlizumab-tmca 10 mg/ml intravenous solution HCPCS J0791 | $7,358.85 | $7,358.85 | $126.70 – $7,358.85 | 110 |
| Cryoprecipitate each unit HCPCS P9012 | $190.00 | $190.00 | $38.19 – $546.00 | 110 |
| Crystal identification light microscopy CPT 89060 | $137.00 | $137.00 | $7.10 – $137.00 | 44 |
| CT 3d report other modality w/workstation CPT 76377 | $546.00 | $546.00 | $109.75 – $546.00 | 26 |
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | $6,179.00 | $6,179.00 | $165.56 – $4,119.00 | 110 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $8,567.00 | $8,567.00 | $329.29 – $8,567.00 | 110 |
| CT Angiogram of the Abdomen CPT 74175 | $4,284.00 | $4,284.00 | $165.56 – $4,284.00 | 110 |
| CT Angiogram of the Abdomen and Both Legs CPT 75635 | $4,665.00 | $4,665.00 | $165.56 – $4,665.00 | 110 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $4,619.50 | $4,384.00 | $165.56 – $4,384.00 | 110 |
| CT Angiogram of the Head CPT 70496 | $5,210.00 | $5,210.00 | $165.56 – $5,210.00 | 110 |
| CT Angiogram of the Neck CPT 70498 | $3,657.00 | $3,657.00 | $165.56 – $3,657.00 | 110 |
| CT angio hrt w/3d image CPT 75574 | $1,200.00 | $1,200.00 | $241.20 – $1,200.00 | 110 |
| CT angio pelvis CPT 72191 | $4,181.00 | $4,181.00 | $165.56 – $4,181.00 | 110 |
| Cta upper extremity w &/or without contrast left CPT 73206 | $4,381.00 | $4,381.00 | $165.56 – $4,381.00 | 110 |
| CT guidance for needle placement CPT 77012 | $1,726.00 | $1,726.00 | $346.93 – $1,726.00 | 26 |
| CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 | $1,789.00 | $1,789.00 | $359.59 – $1,789.00 | 26 |
| CT limited or localized follow-up study CPT 76380 | $1,323.00 | $1,323.00 | $82.14 – $1,323.00 | 110 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $9,207.00 | $9,207.00 | $329.29 – $9,207.00 | 110 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $5,902.00 | $5,902.00 | $329.29 – $5,902.00 | 110 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $4,603.00 | $4,603.00 | $225.21 – $4,603.00 | 110 |
| Culture aerobic additional method definitive id each CPT 87077 | $146.00 | $146.00 | $7.83 – $143.00 | 44 |
| Culture afb any source CPT 87116 | $447.00 | $447.00 | $10.47 – $447.00 | 44 |
| Culture anaerobic additional method definitive id each CPT 87076 | $129.00 | $129.00 | $7.83 – $129.00 | 44 |
| Culture anaerobic except blood CPT 87075 | $25,040.03 | $390.00 | $9.09 – $4,000.24 | 110 |
| Culture body fluid CPT 87070 | $25,040.03 | $298.00 | $8.35 – $4,000.24 | 110 |
| Culture fungi definitive id mold CPT 87107 | $560.00 | $560.00 | $10.00 – $159.00 | 44 |
| Culture fungi definitive id yeast CPT 87106 | $188.00 | $188.00 | $10.00 – $188.00 | 44 |
| Culture fungi other (except blood) CPT 87102 | $277.00 | $277.00 | $8.15 – $277.00 | 44 |
| Culture fungi skin/hair/nail CPT 87101 | $93.00 | $93.00 | $7.47 – $93.00 | 44 |
| Culture mycobacteria definitive id each isolate CPT 87118 | $114.00 | $114.00 | $8.84 – $44.00 | 44 |
| Culture quantitative aerobic other source CPT 87071 | $142.00 | $142.00 | $9.59 – $142.00 | 44 |
| Culture screening strep group a CPT 87081 | $140.00 | $140.00 | $6.43 – $74.00 | 44 |
| Culture typing immunologic CPT 87147 | $39.00 | $39.00 | $5.02 – $39.00 | 44 |
| Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets CPT 87154 | $545.00 | $545.00 | $109.55 – $545.00 | 44 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | $206.00 | $206.00 | $34.01 – $206.00 | 44 |
| Culture urine each isolate CPT 87088 | $1,716.00 | $80.00 | $7.84 – $206.55 | 110 |
| Cutter lead HCPCS C1773 | $5,121.59 | $5,121.59 | $71.94 – $357.89 | 28 |
| Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 | $3.00 | $3.00 | $0.60 – $3.00 | 28 |
| Cyclic citrullinated peptide antibody CPT 86200 | $143.00 | $143.00 | $12.55 – $143.00 | 44 |
| Cyclophosphamide 1 gram intravenous powder for solution HCPCS J9075 | $5,154.25 | $5,154.25 | $259.01 – $1,288.60 | 28 |
| Cyclophosphamide 25 mg capsule HCPCS J8530 | $17.10 | $17.10 | $1.22 – $10.85 | 94 |
| Cyclosporine 250 mg/5 ml intravenous solution HCPCS J7516 | $137.50 | $137.50 | $27.64 – $137.50 | 28 |
| Cyclosporine 2 hour CPT 80158 | $258.00 | $258.00 | $17.49 – $258.00 | 44 |
| Cyclosporine modified 25 mg capsule HCPCS J7515 | $3.35 | $3.35 | $0.20 – $1.20 | 94 |
| Cylinder pump set 20cm titan zero angl HCPCS C1813 | $24,298.69 | $24,298.69 | $10.05 – $50.00 | 28 |
| Cystatin c CPT 82610 | $117.00 | $117.00 | $17.94 – $117.00 | 44 |
| Cystogram >= 3 views supervision & interpretation CPT 74430 | $1,071.00 | $1,071.00 | $215.27 – $1,071.00 | 110 |
| Cystoscopy and treatment CPT 52214 | $19,922.35 | not published | $0.96 – $6,843.44 | 83 |
| Cystoscopy and treatment CPT 52224 | $21,115.93 | not published | $31.45 – $6,843.44 | 83 |
| Cystoscopy and treatment CPT 52234 | $21,730.34 | not published | $183.41 – $6,843.44 | 83 |
| Cystoscopy and treatment CPT 52276 | $17,360.25 | not published | $9.09 – $4,058.30 | 83 |
| Cystoscopy (Bladder Scope) CPT 52000 | $25,734.44 | not published | $9.09 – $1,353.74 | 83 |
| Cystoscopy & ureter catheter CPT 52005 | $37,825.14 | not published | $183.41 – $20,636.89 | 83 |
| Cystouretero w/biopsy CPT 52354 | $22,122.12 | not published | $31.45 – $10,409.46 | 83 |
| Cysto/uretero w/lithotripsy CPT 52356 | $22,367.80 | not published | $0.96 – $10,409.46 | 83 |
| Cystouretero w/stone remove CPT 52352 | $18,818.67 | not published | $9.09 – $6,843.44 | 83 |
| Cystourethroscop/calib/dilat stric 52281 CPT 52281 | $5,896.00 | $5,896.00 | $1,185.10 – $5,896.00 | 108 |
| Cytarabine 20 mg/ml injection solution HCPCS J9100 | $135.00 | $135.00 | $4.40 – $48.40 | 94 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $137.00 | $137.00 | $7.04 – $35.00 | 44 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $278.00 | $278.00 | $16.33 – $278.00 | 44 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $348.00 | $348.00 | $49.19 – $348.00 | 110 |
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | $266.00 | $266.00 | $25.79 – $266.00 | 44 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | $171.00 | $171.00 | $33.96 – $171.00 | 110 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | $215.00 | $215.00 | $33.96 – $215.00 | 110 |
| Cytopathology fna adequacy evaluation each separate additional episode same site CPT 88177 | $217.00 | $217.00 | $8.13 – $217.00 | 28 |
| Cytopathology fna adequacy evaluation first episode each site CPT 88172 | $319.00 | $319.00 | $19.34 – $330.76 | 110 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $460.00 | $460.00 | $49.19 – $460.00 | 110 |
| Cytopath smear other source CPT 88160 | $150.00 | $150.00 | $24.96 – $150.00 | 107 |
| Cytopath tbs c/v manual CPT 88164 | $98.00 | $98.00 | $17.31 – $98.00 | 44 |
| Dacarbazine 100 mg intravenous solution HCPCS J9130 | $56.45 | $56.45 | $4.18 – $55.20 | 94 |
| Dactinomycin 0.5 mg intravenous solution HCPCS J9120 | $13,542.70 | $13,542.70 | $301.83 – $13,542.70 | 110 |
| Dalbavancin 500 mg intravenous solution HCPCS J0875 | $7,773.10 | $7,773.10 | $15.28 – $7,773.10 | 110 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | $127.00 | $127.00 | $12.94 – $64.40 | 94 |
| Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln HCPCS J9144 | $33,713.70 | $33,713.70 | $52.34 – $33,713.70 | 31 |
| Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 | $18,648.65 | $18,648.65 | $2.96 – $932.45 | 110 |
| Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution HCPCS J9153 | $34,410.00 | $34,410.00 | $230.33 – $34,410.00 | 110 |
| Daunorubicin 5 mg/ml intravenous solution HCPCS J9150 | $308.50 | $308.50 | $62.01 – $308.50 | 28 |
| D&c after delivery 59160 CPT 59160 | $16,102.00 | $16,102.00 | $31.45 – $16,102.00 | 108 |
| D&c/diagnostic/therapeutic/non ob 58120 CPT 58120 | $27,722.06 | not published | $94.35 – $11,736.86 | 83 |
| Deamidated gliadin antibody iga CPT 86258 | $196.00 | $196.00 | $11.68 – $196.00 | 44 |
| Debridement bone <= 20 sq cm CPT 11044 | $13,838.05 | $736.00 | $64.12 – $3,206.43 | 769 |
| Debridement/bone/20 sq cm or less 11046 CPT 11046 | $178.00 | $178.00 | $3.83 – $19.20 | 768 |
| Debridement/bone/ea add 20 sq cm 11047 CPT 11047 | $314.00 | $314.00 | $54.32 – $212.00 | 768 |
| Debridement subcutaneous tissue <= 20 sq cm CPT 11042 | $17,324.90 | $1,264.00 | $9.09 – $1,264.00 | 780 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.